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Port Wine Birthmark
Treatment
in New York
Port-wine birthmarks can affect your appearance and self-confidence, but laser treatments are available today to eliminate them in many cases. The board-certified physicians at Laser & Skin Surgery Center of New York are world-renowned for their expertise in treatment port-wine birthmarks with the most effective techniques and treatments available today.
- Downtime: Minimal
- Pain Level: Minimal
- Results Duration: Long-Lasting
Treats:
Port wine birthmarks on the face, hands, arms, and legs
Side Effects:
Slight redness and tenderness immediately following treatment, bruising can last a few days
Location:
Used on the face, hands, arms, and legs
Follow Up:
May require more than one treatment session to achieve full results
How Performed:
Handpiece delivers laser energy to the birthmark
Preparation:
Anesthesia options range from none needed, to topical, local or general anesthesia administered prior to treatment
Procedure Type:
Laser
Expected Outcome:
Reduction or elimination of birthmark
Onset:
Results apparent after final treatment session
Port Wine Birthmark Treatment
We provide comprehensive laser treatments for children and adults with port-wine birthmarks. For children, we begin treatment early in infancy. Laser treatment for port-wine birthmarks is generally effective and safe. Typically, a series of treatment sessions is required to obtain the maximum benefit. The degree of success in the treatment varies based upon the anatomical location of the port-wine birthmark. Treatment is usually suggested as port-wine birthmark most commonly darken and thicken as one ages, sometimes leading to spontaneous bleeding. Our own Dr. Geronemus recently led a groundbreaking study on PWB in infants. The study found that once-weekly pulsed dye laser (PDL) treatments led to either near-total (76%-95% clearance) or total clearance (96%-100%) of the birthmarks in 70% of the infants after just 2 months. These findings suggest that more frequent treatments can significantly improve outcomes quickly and safely, potentially offering a new standard for early PWB intervention.
The physicians at the Laser & Skin Surgery Center of New York are world experts in the area of port-wine birthmark treatments. Our physicians have over thirty (34) years of experience in the treatment of port-wine birthmarks in infants, children, and adults. We see patients across the country and around the globe who seek our experience and expertise to treat even the more challenging markings. We have participated in numerous studies and published multiple articles on this subject to help other practitioners treat their patients effectively. Our center specializes in the outpatient management of patients with this condition and services can also be provided at the New York Eye & Ear Infirmary for those patients requiring general anesthesia.
We utilize a variety of different lasers for the treatment of port-wine birthmarks, including the V-Beam Prima, V-Beam Perfecta, Gentlelase, Alexandrite, Nd:YAG, Excel V, and Fraxel lasers.
We offer a dedicated portion of our practice to treating patients of all ages with port-wine birthmarks, including infants and toddlers. Our office is designed with families and young children in mind, making all of our patients feel comfortable and welcome. Dr. Geronemus believes early intervention through quick, in-office treatments offers a superior outcome. He is a board member of the Vascular Birthmark Association and works with families and other doctors to address vascular birthmarks and tumors. His commitment continues through his Dr. Roy G. Geronemus Humanitarian Scholarship.
Most insurance plans are accepted for treatment, and our insurance staff works diligently to help our patients receive insurance coverage.
After our last visit, I have been giving thought to our conversation regarding the opposition you receive treating patients such as my daughter. We have been coming to see you for a few years, and my husband and I talk on an almost daily basis about how this is the best gift we could have given our little girl. Traveling with a 13 month old during the pandemic, the National Guard checking us into LaGuardia, was not an easy process. However, you and your team have changed our little girl’s life, and ours. We are tremendously and eternally grateful and continue to be. When we started with you treatments had been once every 8 weeks with no bruising (and no observable change).
After about 5 treatments, we were told they could not do much more – and luckily, we found you. Your care, skill and approach has been life changing. I had dreamed that my little lady would be able to make her own decisions one day whether or not she would wear makeup or not – depending on her confidence level. You have allowed this to happen! I am attaching photos from birth and now and the difference is astonishing. This is what we dreamed of for her – thank you is not enough. She is a happy, confident, silly, smart, adorable and wonderful little person. I will try to get a video of her saying that your treatment tickles her and send, too.
What are port wine birthmarks?
Port-wine birthmarks are blue, pink, or red markings on the skin that are frequently present at birth. Most of these birthmarks do not pose a serious medical concern, although they can occasionally be an indication of an underlying condition. People who are self-conscious about a port-wine birthmark can usually have it removed for cosmetic reasons.
Port-wine birthmarks occur when capillaries in the area dilate too much. Capillaries are very small blood vessels, but when blood collects inside of them, it can result in a distinct discoloration on the surface of the skin. Many port-wine birthmarks start out looking pink, but the color can deepen to a reddish-purple hue over time.
Most port-wine birthmarks occur on the face, scalp, neck, arms, and legs. However, the markings can occur anywhere on the body. Most of these birthmarks are not a significant medical concern, although they can be an indication of a serious medical condition in rare instances. However, parents of children with port-wine birthmarks may seek treatment for cosmetic reasons, just as adults with birthmarks often pursue treatment to reduce or eliminate them. Dr. Roy Geronemus did a presentation on Birthmarks at Vascular Birthmarks Foundation Conference in 2020.
One of our very own patients painted these beautiful portraits of people with port-wine birthmarks. You can follow her work on Instagram.
Dr. Geronemus’ Lecture at the 2020 Vascular Birthmark Conference
How do lasers work in treating port wine birthmarks?
Due to the wavelength that the laser operates at, the pulsed dye laser is able to effectively treat the affected area without harming the surrounding skin. This is demonstrated in the following video where Dr. Roy G. Geronemus is able to pop the red balloon with the laser without affecting the white balloon.
How does Port wine birthmark treatment work?
Treatments in the office are performed with either topical anesthesia (EMLA or LMX), local anesthesia or none. We begin treatment in early infancy to facilitate the optimum response and outcome. Typically, multiple treatments are required and a complete cure is not always possible. Treatment intervals will vary based upon the variety of factors including the diagnosis, location of the birthmark, and the age of the patient.
Our physicians have helped develop many, if not most, of the laser technology available today for the treatment of birthmarks. We continually offer the most current treatment for our patients in this rapidly evolving field and we are investigating new technologies for port-wine birthmarks at this time. We would be happy to schedule a consultation to discuss your concerns and create a customized treatment plan to produce the best results for you.
Does Port Wine birthmark Treatment Hurt?
Most port-wine birthmark treatments are comfortable for our patients. In some cases, we might apply a topical numbing cream prior to the procedures to ensure there is no pain associated with the procedure. Other patients may find their treatment to be completely tolerable without any anesthetic or medication. We will take all necessary steps to ensure your treatment experience is positive and comfortable.
When Will I See Results?
You may start to see improvement in your port-wine birthmark soon after your first treatment session. However, most patients require a series of treatments to produce the best possible results. Our doctors will create a treatment plan at your initial appointment so you have an idea of how many sessions you will need to achieve an optimal outcome.
How Long is the Recovery Time After Treatment?
The treated area may turn dark purple-black immediately following your treatment. This discoloration will become somewhat darker over the next several hours and it will remain dark for seven to fourteen days. Surrounding this treated area, you may experience some redness and itching which should resolve within several days. You may experience blisters, scaling, or crusting following the procedure.
If the treated area is near the upper cheek or eye, you should anticipate some swelling. If this occurs, sleep with your head elevated and apply ice packs.
Publications
“Weekly Pulsed Dye Laser Treatments for Port-Wine Birthmarks in Infants.”
JAMA Dermatol. 2024 Apr 17.
“Consensus Statement for the Management and Treatment of Port-Wine Birthmarks in Sturge-Weber Syndrome.”
JAMA Dermatol. 2020 Nov 11
“Assessment of Treatment Tolerance and Parental Perspective of Outpatient Pulsed-Dye Laser Treatment for Port-Wine Birthmark without General Anesthesia in Infants and Toddlers” Journal of the American Academy of Dermatology 2020 September 30
“Treating port-wine stain birthmarks using dynamic optical coherence tomography-guided settings.” J Am Acad Dermatol. 2019 Aug 19
“Case Series of Corneal Eye Shield Application for Laser Treatment of Periocular Port-Wine Stains in Infancy.”
J Am Acad Dermatol. 2020 Jul 29
“Avoiding General Anesthesia in Treating Port-Wine Stains in Infants to Avoid Neurotoxic Events-Reply.” JAMA Dermatology, 2019 July 3
“Pulsed Dye Laser Treatment of Port-Wine Stains in Infancy Without the Need for General Anesthesia.” JAMA Dermatology, 2019 April 1
“Pulsed Dye Laser at Subpurpuric Settings for the Treatment of Pulsed Dye Laser-Induced Ecchymoses in Patients With Port-Wine Stains.” Dermatologic Surgery, 2018 Feb.
“The effect of general anesthesia on Neurodevelopment Abnormalities in children undergoing treatment of vascular anomalies with laser surgery: a retrospective review” Dermatol Surg. 2017 Apr;43(4):534-540
“Treatment of recalcitrant port-wine stains (PWS) using a combined pulsed dye laser (PDL) and radiofrequency (RF) energy device.” J Am Acad Dermatol. 2017 Feb;76(2):321-326. doi: 10.1016/j.jaad.2016.03.004.
“Effect of General Anesthesia on Neurodevelopmental Abnormalities in Children Undergoing Treatment of Vascular Anomalies With Laser Surgery: A Retrospective Review.” Dermatol Surg. 2016 Dec 26
“Successful treatment of two pediatric port wine stains in darker skin types using 595 nm laser.” Lasers Surg Med. 2016 Jan 8
“Laser treatment of port-wine stains.” Clin Cosmet Investig Dermatol. 2015 Jan 12;8:27-33.
“Treatment of Port-Wine Stains With a Short Pulse Width 532-nm Nd: YAG laser.” J Drugs Dermatol. 2013 Jan 1:12(1):66-71.
“High fluence modified pulsed dye laser photocoagulation with dynamic cooling of port wine stains in infancy.” Arch Dermatol 136:942-943, 2000.
“Stress and family satisfaction in parents of children with facial port wine stains.” Ped Dermatol 16(3):190-197, 1999.
“Treatment of port wine stains.” N Engl J Med 339:635-636, 1998.
“Effect of dynamic cooling on 585 nm pulsed dye laser treatment of port-wine stain birthmarks.” Dermatol Surg 23:657-662, 1997.
“Effect of 7 mm vs. 5 mm spot size on pulsed dye laser treatment of port-wine stains and hemangiomas.” Lasers Surg Med 7:56, 1995.
“Pulsed dye laser therapy of resistant port-wine stains.” Dermatol Surg 21:515-521, 1995.
“Anatomical differences of port-wine stains located on the trunk and extremities in response to treatment with the pulsed dye laser” (abstr.) Laser Surg Med 14(suppl 6):47, 1994.
“Anatomical differences in the treatment of port wine stains with the pulsed dye laser.” Arch Dermatol 129:182-188, 1993.
“Treatment of peri-orbital port wine stains utilizing the flashlamp-pumped pulsed dye laser.” Arch Ophthal 110:793-797, 1992.
“Treatment of a port wine stain in a black patient with the pulsed dye laser.” J Derm Surg Oncol 18:147-148, 1992.
“Flashlamp-pumped pulsed dye laser for port wine stains in infancy: Earlier versus later treatment.” J Am Acad Dermatol 24:467-472, 1991.
“The medical necessity of the evaluation and treatment of port wine stains.” J Derm Surg Oncol 17:76-79, 1991.
“Treatment of port wine stains during childhood with the flashlamp-pumped pulsed dye laser.” J Am Acad Dermatol 23:1142-1148, 1990.
“The use of the pulsed dye laser for the treatment of port-wine stains in children.” N Engl J Med 321:901-902, 1989.
Real Patients Before and After photos
Laser treatment to remove port wine birthmark from infant’s face
Laser treatment for port wine birthmark on infant’s back
Laser treatment to reduce the appearance of a port wine birthmark from infant’s face
Port-Wine Birthmark Treatment In The News
Weekly PDL treatments associated with improved port-wine birthmark therapeutic outcomes in infants
Weekly Pulsed Dye Laser Treatments for Port-Wine Birthmarks in Infants
How early can laser treatment for port-wine stains in infants be initiated?
How Early Can Laser Treatment For Port Wine Stains in Infants Be Initiated?, featuring Dr. Geronemus
Port Wine Birthmark Treatment
Questions and Answers
Q: Is Port-Wine Treatment Safe?
A: Yes. All of the lasers we use for this treatment are FDA-approved and have extended track records of safety and success. In addition, our board-certified physicians have ample experience and expertise in using these device3s to ensure ou patients’ treatment sessions are both safe and successful.
Q: Why Laser Treatment for Port-Wine Birthmarks?
A: We are fortunate that the treatment of port-wine birthmarks is generally effective and safe. Laser therapy is considered the treatment of choice for port-wine birthmarks. Typically, a series of treatment sessions are required to obtain the maximum benefit of laser treatment in port-wine birthmarks. The degree of success in the treatment varies based upon the anatomical location of the port-wine birthmark. Treatment is usually suggested as port-wine birthmarks most commonly darken and thicken as one ages, sometimes leading to spontaneous bleeding.
Q: Which Lasers should be used for Treatment?
A: There are several lasers available for port-wine birthmark treatment. The most commonly used is the pulsed dye laser (Vbeam Perfecta). We also use the Cynergy laser and the Excel V. The choice of laser is based on the characteristics of the birthmark.
Q: How Effective is Laser Treatment?
A: The data from the treatment of port-wine birthmarks is variable in terms of the clinical response. Recently published studies have shown an improvement ranging anywhere from 75-100% following a series of treatment sessions. More recently, improved technology and treatment protocols have allowed for a tendency towards more lightening and clearing of port-wine birthmarks. A recent study from our Center revealed close to 90% clearing when treatment begins in infancy.
Q: Are There Any Side Effects From Port Wine Birthmark Treatment?
A: The treated area may turn dark purple or black immediately following your treatment. This discoloration will become somewhat darker over the next several hours and it will remain dark for 7 to 14 days. Surrounding this treated area, you may experience some redness and itching which should resolve within several days. It is possible that you may experience several blisters, scaling or crusting following the procedure.
If the treated area is near the upper cheek or eye, you should anticipate some swelling. If this occurs, sleep with your head elevated and apply ice packs.
Q: When should Treatment Begin?
A: Treatment protocols and choice of technology may vary from physician to physician. In my experience, early intervention makes a significant difference. I prefer to initiate treatment during early infancy with treatment parameters that approximate those given to adults at relatively short intervals of two to four weeks. This “window of opportunity” during infancy allows for more complete clearing than is seen with older patients in all anatomical sites. Treatments have begun as early as several days of age.
Q: How is Treatment During Infancy Handled?
Dr. Geronemus and the physicians at Laser & Skin Surgery Center of New York have pioneered the treatment of infants with port-wine birthmarks. We believe that early intervention will lead to a faster and more complete response to treatment while minimizing the requirements for anesthesia. While we offer all options for anesthesia (see below) treatment during infancy can usually be performed without the need for anesthesia and is well tolerated by the babies. Our physicians are experts at the placement of protective ocular shields in the office setting, allowing for the treatment of the upper and lower eyelids during infancy.
Q: Do All Areas Respond the Same to Treatment?
A: There are some areas that are more difficult to treat than others. Typically, the central portion of the face and the lower arms, hands, lower legs and feet are much more resistant to therapy that other anatomical sites.
Q: What does the Skin Look Like after Treatment?
A: In almost all cases there is bruising following each treatment session that will last for approximately seven to fourteen days. The risks from these laser treatments are small. Textural and pigmentary changes following treatment are not common.
What are the Options for Anesthesia or Pain Control?
A: We are often asked by parents and patients to comment on the choices for anesthetics for port-wine birthmark treatment. For young infants, we typically will not give topical or general anesthesia unless we are dealing with a very large area. We defer the use of topical anesthesia until the child is one or two years of age, depending upon the choice of topical anesthetic. We sometimes use general anesthesia on a same-day surgery basis for those children who are uncooperative in the office setting or have large birthmarks that require a significant amount of time. In adults, topical anesthesia is usually sufficient to achieve a comfortable treatment.
Q: What are the Qualifications of the Physicians at Laser & Skin Surgery Center of New York?
A: The physicians at Laser & Skin Surgery Center of New York are amongst the most experienced in the world in the treatment of port-wine birthmarks. We continually upgrade our technology to offer our patients the best treatment possible. We lecture nationally and internationally regarding our experience. We also publish extensively in peer-reviewed literature and are presently investigating new technologies and techniques to improve port wine stain treatment.
Q: I am Interested in Traveling to NY for Treatment. How do I Make Arrangements?
Many of our patients and their families travel to our center for treatment from across the country and internationally. You may call the office for an appointment or series of appointments. Our staff can be of help with supporting documentation required for entry into the US or with insurance issues.
Q: Are there Support Groups Available for Patients with Birthmarks?
A: Children and adults undergoing laser treatment of their port-wine birthmarks often require significant support from their family and friends as this is a long process that usually leads to significant physical and psychological benefits.
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